夜戴型角膜塑形镜对儿童眼表体征和症状的影响

The influence of overnight orthokeratology on ocular surface signs and symptoms in children

目的评价夜戴型角膜塑形镜对不同近视组儿童眼表体征和症状的影响。方法前瞻性研究。选取12-18岁近视患儿观察58例夜戴型角膜塑形镜佩戴者,其中低度近视组33例,中度近视组25例。分别于戴镜前、戴镜后1周、戴镜后1月、戴镜后3月、戴镜后6月行泪湖高度、非侵入性泪膜破裂时间(noninvasive tear film breakup time,NIBUT)、角膜荧光染色和眼表疾病指数问卷(ocular surface disease index,OSDI)检查。使用SPSS22.0分析处理数据。结果与基线(戴镜前)相比,NIBUT在戴镜后1周、1月、3月和6月显著下降(F=4.844,P=0.003)。角膜荧光染色评分在戴镜后1周、1月、2月、3月和6月显著升高(F=5.482,P=0.001)。OSDI评分(F=4.920,P=0.005)、泪湖高度(F=5.482,P=0.001)与基线相比无显著差异。不同近视组别泪湖高度(F=0.828,P=0.367)、非侵入性泪膜破裂时间(F=2.200,P=0.144)、角膜荧光染色评分(F=0.10,P=0.919)、OSDI评分(F=2.539,P=0.1174)在相同时间点无差异。结论儿童短期佩戴夜戴型角膜塑形镜虽然会增加角膜荧光染色评分和降低泪膜的稳定性,但是会降低主观不适感。

Objective To investigate the influence of overnight orthokeratology on ocular surface signs and symptoms in children of different myopia groups.Methods 58 subjects with overnight orthokeratology were observed.The height of meniscus,noninvasive tear film breakup time(NIBUT),corneal fluorescein staining,the ocular surface disease index(OSDI)were measured before and at 1week,1month,2 months,3months and 6 month after wearing the overnight orthokeratology.The statistical analysis was conducted with SPSS 22.0.Results Significant decrease in NIBUT was.observed compared with baseline values at 1 week,1month,3 months and 6 months(P<0.05).Significant increase in corneal staining scores was observed compared with baseline values at 1week,1 month,3months and 6 months(P<0.05).No significant changes were observed in OSDI and the height of meniscus(P>0.05).The height of meniscus,NIBUT,the corneal staining scores and the OSDI scores of different myopia group are no difference at the same time.Conclusion The overnight orthokeratology decreased the tear film stability and increased corneal fluorescein staining scores,but the.overnight orthokeratology did not cause contact lens discomfort.